Grief & Loss

Question 1

A client who has been in recovery from alcohol use disorder for over one year tells the nurse they have been drinking 5 to 6 beers per night since the client’s parent’s death. Which is the nurse’s most accurate explanation for the client’s grief response?

A. emotional
B. behavioral
C. spiritual
D. physiologic

Answer 1

B. Behavioral

The nurse can explain to the client this is a behavioral response to grief. Substance and alcohol use indicates the client has developed a maladaptive response to the spiritual and emotional despair related to the death of the parent. Emotional responses to grief are characterized by expressing various emotions throughout the grieving process. Alcohol use is not an emotional response to grief. However, it is a behavior that is used to attempt to manage the emotional pain associated with the loss. Spiritual responses to grief are related to an individual’s values regarding the spiritual dimension of the human experience. Although alcohol use is not a spiritual response to grief, it can be a behavioral response to the spiritual discord the client may be experiencing while processing the parent’s death. Physiologic responses to grief refer to the natural body responses that emerge for the body to adapt to loss. Although the client may use alcohol to try to treat a physiologic response to grief—for example, to promote sleep or calm anxiety—it remains a behavioral response.

Question 2

The nurse is assessing a client who is deeply upset and is not expressing feelings. At the end of the assessment, the nurse concludes that the client is extremely depressed because of the death of a loved one. The client has disenfranchised grief. What is the most likely reason the client is unwilling to speak about it to the nurse?

A. The client wants to forget about the person who is dead.
B. The client does not yet feel ready to talk about their feelings.
C. The client feels that the nurse cannot make the client feel better.
D. The client feels uncomfortable speaking about the relationship with the deceased.

Answer 2

D. The client feels uncomfortable speaking about the relationship with the deceased.

Disenfranchised grief is grief over a loss that cannot be acknowledged openly or publicly or is considered socially unacceptable. These include the loss of a loved one in secret or closeted same-sex relationships, cohabitation without marriage, and extramarital affairs. The stigma associated with the relationship between the client and the deceased would not allow the client to express feelings about the relationship to the nurse comfortably.